Trends in the Age of Primigravidae in Enugu, Nigeria

Objective: To assess the trend in the age of primigravidae at a tertiary care centre in Enugu, Eastern Nigeria. Study Design, Setting and Subjects: An analysis of the birth records of all primigravidae who delivered in the hospital over a twenty-one year period. Trends were assessed by chi-square and one-way analysis of variance (ANOVA) tests at the 95% confidence level. Results: The proportion of primigravidae significantly increased from 17.4% of all parturients in 1980 to 24.1% in 2000. The proportion of teenage primigravidae significantly decreased while that of elderly primigravidae significantly increased (p < 0.001 for each variable). The mean age of the primigravidae also significantly increased from 21.0 ± 4.1 years in 1980 to 27.6 ± 4.5 years in 2000. Conclusion: Over the last twenty-one years, there has been a significant increase in the mean age of primigravidae and the proportion of elderly primigravidae and a significant decrease in the proportion of teenage primigravidae in Enugu, Nigeria. Key Words: Trends, Temporal, Primigravida, Maternal Age. [Trop J Obstet Gynaecol, 2002, 19: 71-73

The Use of the Foley Catheter in Controlling Severe Uterine Haemorrhage in Gynaecological Practice

Three patients with severe uterine bleeding were managed successfully by intracavitary insertion and distension of Foley catheter balloons. Blood transfusion was averted in the first patient and reduced to 2 units in the second, while imminent maternal death was prevented in the third case. The availability of the Foley catheter and minimal requirements for its use, coupled with lack of untoward effects in cases managed, make the procedure a useful one. Key Words: Uterus, Haemorrhage, Foley Catheter. [Trop J Obstet Gynaecol, 2002, 19: 44-46

Cervical Cancer Screening: A Survey of Current Practice Amongst Nigerian Gynaecologists

Context: Cervical malignancy is the commonest genital tract malignancy in Nigeria. In the absence of a national screening programme, any hope of minimising death from invasive cervical carcinoma in Nigeria is through increased opportunistic cervical screening by physicians. Recent evidence showed a high awareness but a low practice of cervical screening among Nigerian women, a situation that the respondents attributed to poor physician referral. Objective: To study the attitude toward and practice of cervical cancer screening amongst Nigerian gynaecologists, on whom the burden of treating cervical cancer rests. Study Design, Setting and Subjects: A self-administered, questionnaire survey of 113 Nigerian gynaecologists who attended the Annual General Meeting and Scientific Conference of the Society of Gynaecology and Obstetrics of Nigeria (SOGON) held in Abuja in November 2000. Results: The 86 (76.1%) gynaecologists who practised in centres with cervical screening services estimated that they screened 15.0 + 18.9% of their gynaecology patients. Pap smear was available to 85 (76.1%) gynaecologists, colposcopy to 28 (32.6%), direct visual inspection (after applying 5% acetic acid solution) to 16 (18.6%), human papillomavirus (HPV) DNA testing to 2 (2.3%) and cervicography to 1 (1.2%). Thirty gynaecologists had definite cervical screening programmes, most of which were selective and based on specific indications. All the respondents favoured a national cervical screening programme. Conclusion: Despite general agreement amongst Nigerian gynaecologists on the need for a national cervical screening programme, their level of opportunistic screening of patients is currently low. A plea is made for increased opportunistic screening pending the establishment of a national screening programme. (Tropical Journal of Obstetrics and Gynaecology: 2001, 18(2): 78-81

Factors associated with the use of maternity services in Enugu, southeastern Nigeria

The maternal mortality ratio and other maternal health indicators are worse for developing countries than for the developed world due to improved access to quality care during pregnancy and especially at delivery in the industrialized world. This study was carried out to identify the factors which influenced choice of place of delivery by pregnant women in Enugu, southeastern Nigeria, and to recommend ways to improve women's access to skilled attendants at delivery. A pre-tested questionnaire was administered by interviewers to women who had delivered within 3 months prior to date of data collection. The response rate was 75.5% (n=1098). Of the respondents, 52.9% delivered outside health institutions and 47.1% in health institutions. The major factors influencing choice of place of delivery included promptness of care, competence of midwife/doctor, affordability, health education, 24 h presence of doctors, team work among doctors and presence of specialist obstetricians. There were statistically significant associations between choice of institutional or non-institutional deliveries and socio-demographic/economic factors such as place of residence (urban/rural), religion, educational status, tribe, marital status, occupational level, husband's occupational and educational levels, age and parity (pMaternity utilization Associated factors Enugu Nigeria